Frontiers in psychology
Association between unintentional injuries and suicidal ideation of children and adolescents: a longitudinal study
By Yang Y, Chen B, Chen Z and 2 others.
Abstract
Purpose
This study aims to investigate the prospective association between unintentional injuries and subsequent suicidal ideation among children and adolescents.
Methods
This study is a two-wave longitudinal school-based cohort derived from repeated surveys administered in Anhui, China, in November 2023 (Wave 1) and April 2025 (Wave 2). As grade 12 students in Wave 1 would graduate by July 2024 and thus be unavailable for follow-up, we included only students in grades 5-11 from Wave 1. We identified 24,522 students who participated in both waves, yielding a follow-up rate of 84.18% (47.08% female).
Results
Among 12 types of unintentional injuries, after adjustment for socio-demographic characteristics and Wave 1 suicidal ideation, all 12 types were significantly associated with Wave 2 suicidal ideation, with adjusted odds ratios ranging from 1.31 to 1.65; all associations remained significant after Benjamini-Hochberg FDR correction (q < 0.05). The strongest associations were observed for explosion injuries (OR = 1.65, 95% CI = 1.27-2.13, q < 0.001), injuries from sharp objects (OR = 1.62, 95% CI = 1.50-1.75, q < 0.001), and poisoning (OR = 1.54, 95% CI = 1.19-1.99, q = 0.001), while the weakest, though still significant, was for Swallow a foreign object (OR = 1.31, 95% CI = 1.21-1.42, q < 0.001). Formal interaction tests indicated that only 3 of the 12 injury types (fall injuries, explosion injuries, and electric-current exposure) showed statistically significant gender × injury interactions, suggesting that the overall pattern of associations is largely consistent across sexes.